Post-prostatectomy incontinence treatment usually begins with pelvic floor rehabilitation soon after surgery. If bladder control is slow to return, treatment may progress from exercises and assisted muscle stimulation to specialist evaluation and, for persistent stress incontinence, procedures such as a male sling or artificial urinary sphincter.
Updated: September 3, 2026
Reviewed by: Dr. Adeena Reeham
Urinary leakage is common after radical prostatectomy, but that does not mean men simply have to wait for it to go away. Treatment can begin during the early recovery period and change over time depending on how quickly bladder control returns.
The most appropriate treatment depends on the type and severity of leakage, how long it has been since surgery, whether symptoms are improving, and how much the incontinence is affecting everyday life. Most men begin with conservative rehabilitation before considering surgical treatment.
If you are primarily looking for information about why leakage occurs and how long it typically lasts, see our guide to urinary incontinence after prostate surgery. This article focuses specifically on what can be done to treat it.
Pelvic floor rehabilitation does not need to wait until incontinence becomes persistent. Current clinical guidance recommends offering pelvic floor muscle exercises or pelvic floor muscle training in the immediate postoperative period after radical prostatectomy.
That matters because the first goal after surgery is usually to help the pelvic floor and urinary sphincter regain strength, endurance, and coordination as healing progresses.
For many men, treatment follows a progression:
The important distinction is that treatment does not have to mean surgery. For most men, treatment begins conservatively.
Pelvic floor muscle training, often called Kegel exercises, is one of the first treatments recommended after prostatectomy. These muscles help support urinary control after removal of the prostate changes the anatomy around the bladder and urethra.
A good program focuses not only on making the muscles stronger, but also on contracting the correct muscles, relaxing between contractions, and developing enough endurance to maintain control during activities such as standing, coughing, lifting, walking, and exercise.
Technique matters. Men sometimes compensate by tightening the abdomen, buttocks, or thighs instead of isolating the pelvic floor. A pelvic floor physical therapist can help identify the correct muscles and may use biofeedback to make training more effective.
See our detailed guide to Kegel exercises for men for technique, common mistakes, and postoperative training considerations.
Electrical stimulation is another approach used to activate pelvic floor muscles when voluntary contractions are difficult, inconsistent, or need additional support. Rather than relying entirely on the patient to perform each contraction correctly, neuromuscular electrical stimulation generates repeated muscle contractions during treatment.
Research on electrical stimulation after prostatectomy has produced mixed results, but recent evidence suggests it may help accelerate continence recovery when used as part of pelvic floor rehabilitation. European guidelines currently state that pelvic floor muscle training may be offered alone or in combination with biofeedback and/or electrical stimulation to speed recovery after radical prostatectomy.
Elitone for Men is an FDA-cleared, external pelvic floor stimulation treatment designed to aid early continence recovery after prostate surgery. It delivers neuromuscular stimulation through the skin to repeatedly activate the pelvic floor without requiring an internal probe, providing structured at-home therapy alongside the recovery process.
For a deeper look at how this treatment works and how it differs from other forms of stimulation, see electrical stimulation for male incontinence.
Pelvic floor rehabilitation addresses the underlying continence mechanism, while practical strategies can make leakage easier to manage during recovery.
These strategies can reduce day-to-day disruption, but pads and other containment products manage the leakage rather than rehabilitating the muscles involved in bladder control.
| Treatment | Best Fit | Invasive? | Primary Role |
|---|---|---|---|
| Pelvic floor exercises | Early recovery; mild leakage | No | Strengthen and retrain pelvic floor |
| Pelvic floor physical therapy | Technique problems or need for guided rehabilitation | No | Supervised training, coordination and biofeedback |
| External NMES / Elitone for Men | Early continence recovery; men needing assisted pelvic floor activation | No | Produces repeated pelvic floor contractions at home |
| Pads / protective underwear | Any stage while leaks continue | No | Manage leakage; does not correct the underlying continence mechanism |
| Penile clamp | Selected men needing temporary control | No surgery | Mechanically prevents leakage while worn |
| Male sling | Persistent mild-to-moderate stress incontinence | Yes – surgical | Supports/compresses urethra |
| Artificial urinary sphincter | Persistent moderate-to-severe stress incontinence | Yes – surgical | Provides mechanical urinary control |
Some leakage during the early months after prostatectomy is expected, and many men continue to improve as healing and pelvic floor rehabilitation progress. However, persistent or severe leakage deserves further evaluation rather than simply assuming more time will solve the problem.
Talk with your urologist if:
A urologist can determine whether the leakage is primarily stress incontinence caused by sphincter weakness, urgency incontinence related to bladder function, or a combination of both. This distinction matters because treatment differs depending on the underlying problem.
For men with bothersome stress urinary incontinence that is not improving despite conservative therapy, surgical treatment may sometimes be considered as early as six months after prostate treatment. By one year, persistent bothersome stress incontinence should generally prompt discussion of surgical treatment options.
A male sling is a surgically implanted strip of material positioned beneath the urethra. It helps reposition and support the urethra so that it remains closed more effectively during activities that increase abdominal pressure.
Slings are generally considered for men with mild-to-moderate stress urinary incontinence. Outcomes may be less favorable in men with severe leakage or a history of pelvic radiation, so careful evaluation is important before choosing this option.
Unlike an artificial urinary sphincter, a sling does not require the patient to operate a device each time he urinates. However, it is still surgery and carries risks that should be discussed with a urologist experienced in male incontinence treatment.
An artificial urinary sphincter (AUS) is an implanted system designed to replace some of the closing function lost when the natural urinary sphincter cannot adequately prevent leakage.
The system typically includes a cuff placed around the urethra, a pressure-regulating component, and a small pump placed in the scrotum. The cuff normally keeps the urethra closed. When the man needs to urinate, he squeezes the pump to temporarily open the cuff and allow urine to pass.
The artificial urinary sphincter has long been considered a standard surgical treatment for men with moderate-to-severe stress urinary incontinence after prostate surgery. It can substantially reduce leakage and pad use, although it requires surgery and the implanted components may eventually require revision or replacement.
For this reason, an AUS is generally considered after conservative approaches have failed and when the severity of leakage justifies a surgical solution.
There is no single post-prostatectomy incontinence treatment that is right for every man. The best approach depends heavily on where you are in recovery and whether bladder control is continuing to improve.
During the early postoperative period, the emphasis is usually on restoring pelvic floor function. Pelvic floor exercises, physical therapy, and assisted muscle activation can all play a role. Elitone for Men provides external neuromuscular electrical stimulation designed to aid early continence recovery after prostate surgery, creating repeated pelvic floor contractions without requiring an internal probe.
For men who are still leaking during recovery, pads or other containment products can make daily life easier, but they do not rehabilitate the continence muscles. A penile clamp can also provide temporary mechanical control for selected men, although it similarly manages leakage rather than improving the underlying continence mechanism.
When significant stress incontinence persists despite appropriate conservative treatment, the conversation changes. At that point, a urologist can evaluate whether a male sling, artificial urinary sphincter, or another intervention is appropriate.
The goal is therefore not necessarily to choose one treatment and stay with it indefinitely. Post-prostatectomy incontinence treatment can evolve with recovery: rehabilitate early, monitor improvement, and escalate treatment when recovery plateaus or leakage remains significantly bothersome.
For most men early in recovery, treatment begins with pelvic floor rehabilitation, including pelvic floor muscle exercises and, when appropriate, physical therapy or electrical stimulation. Men with persistent bothersome stress incontinence may eventually be candidates for a male sling or artificial urinary sphincter. The best treatment depends on severity, time since surgery, and whether continence is still improving.
Continence often improves substantially during the first several months after prostatectomy, with additional recovery possible through the first year. Men whose bothersome stress incontinence is no longer improving may discuss surgical options with their urologist as early as six months, while persistent bothersome incontinence at one year generally warrants evaluation for surgical treatment.
Pelvic floor muscle exercises can help speed the return of continence after prostatectomy, particularly during early recovery. Correct technique and consistency matter. Men who have difficulty identifying or effectively contracting the pelvic floor may benefit from guided pelvic floor rehabilitation or assisted muscle activation.
Electrical stimulation activates the pelvic floor muscles using electrical signals rather than relying solely on voluntary contractions. Clinical evidence is mixed, but guidelines recognize pelvic floor muscle training with biofeedback and/or electrical stimulation as an option that may help speed continence recovery after radical prostatectomy. Learn more about electrical stimulation for male incontinence.
A male sling is generally considered for persistent mild-to-moderate stress urinary incontinence after conservative treatment has not provided adequate control. Men with severe leakage or prior pelvic radiation may be less likely to benefit from a sling and may be better candidates for other treatments.
An artificial urinary sphincter is commonly used for moderate-to-severe stress urinary incontinence that persists after prostate surgery despite conservative treatment. A urologist can evaluate whether the severity and type of leakage make an AUS appropriate.
No. Pads absorb leakage and penile clamps mechanically prevent urine from escaping while in use. They can be useful for managing leakage, but they do not rehabilitate the urinary sphincter, pelvic floor, or other continence mechanisms affected by prostate surgery.
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